title: Early deaths in pediatric acute leukemia: a population-based study.
abstract: The purpose was to describe the incidence and risk factors associated with early deaths (≤ 42 days from diagnosis) among children with acute lymphoblastic leukemia (ALL) and acute myeloid leukemia (AML) in Ontario, Canada. The data source for this population-based, retrospective cohort study was the Pediatric Oncology Group of Ontario Networked Information System (POGONIS). Patients with acute leukemia aged ≤ 18 years diagnosed between 1990 and 2010 were included. The study population consisted of 1954 children with ALL and 403 with AML. The early death rate was 40/2357 (1.7%), with 1.1% of patients with ALL and 4.7% of patients with AML dying early. Among all 442 deaths recorded, 9.0% occurred early. Twelve/40 (30.0%) early deaths were attributed to infection. Factors associated with early deaths were AML (p < 0.0001) and age ≥ 10 years at diagnosis (p = 0.038). Future interventions to improve survival may consider focusing on the early treatment period and may target AML and older patients.
authors.affiliation: Department of Paediatrics, University of Toronto , Toronto, Ontario , Canada.
authors.forename: Sylvia
authors.initials: S
authors.lastname: Cheng
authors.forename: Jason D
authors.initials: JD
authors.lastname: Pole
authors.forename: Lillian
authors.initials: L
authors.lastname: Sung
mesh_terms: D000293:Adolescent; D002423:Cause of Death; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D015994:Incidence; D015470:Leukemia, Myeloid, Acute / Q000453:epidemiology / Q000401:mortality*; D008297:Male; D009864:Ontario / Q000453:epidemiology; D011159:Population Surveillance; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000453:epidemiology / Q000401:mortality*; D012042:Registries; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors
keywords: Leukemia; Ontario; early deaths; mortality; pediatric; population-based